Exercise aggravates this disease!

One of the common symptoms of prolonged COVID-19 is a tendency to engage in strenuous exercise, which worsens the condition.

The long-term effect of the coronavirus is not only to reduce a person's exercise capacity, but widespread symptoms often appear in the days following training sessions. Researchers have called this phenomenon “post-exercise malaise” (PEM), and it is a relatively strange phenomenon. .


Physiological explanations and foundations

According to the New Atlas website, citing two studies published in the journal ERJ Open Research and Nature Communications, exercise is beneficial in most rehabilitation cases, and when a patient is affected by exercise, there is usually a clear physiology. Explanations may be that the heart or lungs are not working properly, or that long-term illness has led to a type of physical deterioration that usually weakens the body.

But in many cases of long-term Covid-19, there are no clear symptoms that explain exercise restrictions. Many patients have been hit by traditional tests and told they are fine, but many new studies are beginning to unravel the mystery behind. A long-term infection with the corona virus.

While the results don't point to immediate solutions, they do confirm that the phenomenon of chronic exercise intolerance associated with the coronavirus has physiological underpinnings.

Cardiopulmonary exercise testing

A more traditional test of a patient's functional physical capacity is called a cardiopulmonary exercise test (CPET). The patient is placed on an exercise bike while doctors monitor heart rate, oxygen saturation and electrocardiogram data.

For many long-term coronavirus patients, CPET investigations yield unusually normal results. Despite apparent limitations to exercise such as dyspnea, these patients often show normal oxygen levels and healthy heart function.

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Invasive cardiopulmonary exercise

A team of Yale University researchers conducted a study on a group of chronic coronavirus patients that included a new CPET test, called iCPET, or invasive cardiopulmonary exercise test, which is more complex than the conventional CPET test. In addition to conventional CPET procedures, two pressure-sensitive catheters are inserted into the arteries of patients undergoing this test, allowing additional visualization of the effect of exercise on muscles and blood vessels.

Proper oxygen extraction

The results were surprising, showing no significant problems with the way the heart or lungs were working, but they did reveal clear abnormalities in the way the body's tissues took up oxygen. Impaired systemic oxygen extraction was classified as pEO2.

The study's principal investigator, Peter Kahn, explained that it was found that “even though the heart was pumping oxygenated blood supplied by the lungs with sufficient oxygen, the extraction of oxygen from the body's tissues was compromised in patients who showed symptoms.” Exercise intolerance.” Sports after Covid. But researchers cannot pinpoint exactly why or how this happened, as the researchers pointed to several possible explanations for this unusual phenomenon.

The study's researchers hypothesized that “deficient pEO2 may result from inadequate contractility of non-exercising vascular beds or inadequate direct muscle blood flow or capillary diffusion to mitochondria.”

Interesting source

A study recently published in the journal Nature Communications conducted by a team of scientists at the University of Amsterdam provides interesting clues about what's going on. The answer appears to be related to mitochondria, the tiny powerhouses that power individual cells.

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The University of Amsterdam's most unique trial included chronic coronavirus patients and a healthy control group. Study participants completed a grueling cycling test, providing blood and muscle tissue samples one week before and one day after the test.

Abnormalities in muscle tissue

Researcher Rob West, who was involved in the study, said signs of poor metabolism and significant muscle damage were found in Covid patients long after intense exercise. Perhaps most importantly, the results revealed that intense exercise actually caused mitochondrial dysfunction in muscle cells, which may explain why long-term Covid patients feel worse the day after physical activity.

“We found various abnormalities in the muscle tissue of the patients. At the cellular level, we found that the mitochondria in the muscles, the so-called energy factories of the cells, were less active and produced less energy from the cells,” explains Foust. .


Mitochondrial dysfunction

Mitochondrial dysfunction has previously been hypothesized as a possible explanation for the long-term symptoms of some coronaviruses, but how SARS-CoV-2 infection causes mitochondrial dysfunction remains a mystery. Although exercise has always been thought to benefit mitochondrial function, this rule may not apply to people with diabetes, Foust noted. [كوفيد طويل الأمد]. Apparently, muscle damage and the resulting immune cell infiltration can also reduce mitochondrial function.

Light physical exertion

Brent Appleman, a co-researcher on the Amsterdam study, said long-term Covid patients should be careful not to burden themselves beyond their limits. It is now clear that overexertion is harmful, and the cause is tentatively understood.

“Certainly, these patients can be counseled,” Appleman says [المتعافين من كوفيد طويل الأمد] By maintaining their physical limits and not exceeding them, they can make a light effort that does not worsen the complaints,” noting that “it is better to walk or ride an electric bike to improve health, maintain certain physical fitness, and one may stress that each is suitable for the other. to keep in mind.

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